Inflammatory Biomarkers as Predictors of In‐Hospital Mortality in Critically Ill COVID‐19 Patients: A Retrospective Cohort Study
- 1Guilan University of Medical Sciences
- 2Zabol University of Medical Sciences
Abstract
Background and Aim Inflammatory biomarkers have been proposed as prognostic indicators in COVID‐19; however, their prognostic associations within critically ill ICU‐admitted patients remain of interest. This study aimed to evaluate the associations of selected inflammatory biomarkers with in‐hospital mortality and their discriminatory performance among critically ill COVID‐19 patients. Methods In this retrospective cohort study, 244 adult patients with confirmed COVID‐19 pneumonia admitted to the ICU between August 2020 and June 2021 were analyzed. Disease severity was assessed using the ISARIC 4 C Mortality Score. Associations between inflammatory biomarkers and mortality were evaluated using univariable and multivariable logistic regression, and discriminatory performance was assessed using ROC curve analysis. Results The in‐hospital mortality rate was 90.6%. ESR and LDH levels were significantly higher in non‐survivors. In a biomarker‐restricted multivariable logistic regression model, ESR (OR 1.023 per 1 mm/h increase; 95% CI 1.004–1.042; p = 0.016) and LDH (OR 1.002 per 1 U/L increase; 95% CI 1.000–1.003; p = 0.009) remained significantly associated with in‐hospital mortality after mutual adjustment for the other prespecified inflammatory biomarkers. LDH demonstrated good discriminatory performance (AUC 0.725; 95% CI 0.645–0.805). ESR showed modest discriminatory performance (AUC 0.646; 95% CI 0.559–0.732). Conclusion ESR and LDH remained significantly associated with in‐hospital mortality after adjustment for the other prespecified inflammatory biomarkers. These findings suggest that ESR and LDH may provide adjunctive prognostic information in critically ill ICU patients; however, they should be interpreted in the context of the biomarker‐restricted model and the limited adjustment set. Confirmation in larger prospective studies incorporating established clinical prognostic factors is warranted.
Related
- Association of Body Mass Index with Early Inflammatory and Coagulation Biomarker Patterns and Intensive Care Unit Mortality in Critically Ill Patients with COVID-19: A Retrospective Cohort Study
- Temporal patterns of respiratory rate exposure and mortality in critically ill patients: a retrospective multi-database cohort study
- Association of first-24-hour hypernatremia and hyperkalemia co-occurrence with 30-day mortality in critically ill adults: a retrospective cohort study
- LDAR shows more consistent prognostic performance than other albumin-derived indices for 28-day ICU mortality in critically ill patients with urosepsis: evidence from a dual-cohort retrospective study
- Survival Status and Predictors of Mortality Among Women With Breast Cancer in Southern Ethiopia: A Retrospective Cohort Study
BibTeX
@article{rimaz2026inflammatory,
title = {{Inflammatory Biomarkers as Predictors of In‐Hospital Mortality in Critically Ill COVID‐19 Patients: A Retrospective Cohort Study}},
author = {Siamak Rimaz and Orchideh Amoie Foumani and Hamid Hoseinzadeh and Mohammad Shokri and Mohammad Haghighi and Mahboobeh Gholipour and Nastaran Najd and Amirhossein Azariyan and Mohammadreza Mobayen and Mahsa Sadeghi},
journal = {Health science reports},
year = {2026},
month = oct,
doi = {10.1002/hsr2.73411},
url = {https://europepmc.org/article/PMC/PMC13691528},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Inflammatory Biomarkers as Predictors of In‐Hospital Mortality in Critically Ill COVID‐19 Patients: A Retrospective Cohort Study
AU - Siamak Rimaz
AU - Orchideh Amoie Foumani
AU - Hamid Hoseinzadeh
AU - Mohammad Shokri
AU - Mohammad Haghighi
AU - Mahboobeh Gholipour
AU - Nastaran Najd
AU - Amirhossein Azariyan
AU - Mohammadreza Mobayen
AU - Mahsa Sadeghi
PY - 2026
DA - 2026/10/22
JO - Health science reports
DO - 10.1002/hsr2.73411
UR - https://europepmc.org/article/PMC/PMC13691528
AB - Background and Aim Inflammatory biomarkers have been proposed as prognostic indicators in COVID‐19; however, their prognostic associations within critically ill ICU‐admitted patients remain of interest. This study aimed to evaluate the associations of selected inflammatory biomarkers with in‐hospital mortality and their discriminatory performance among critically ill COVID‐19 patients. Methods In this retrospective cohort study, 244 adult patients with confirmed COVID‐19 pneumonia admitted to the ICU between August 2020 and June 2021 were analyzed. Disease severity was assessed using the ISARIC 4 C Mortality Score. Associations between inflammatory biomarkers and mortality were evaluated using univariable and multivariable logistic regression, and discriminatory performance was assessed using ROC curve analysis. Results The in‐hospital mortality rate was 90.6%. ESR and LDH levels were significantly higher in non‐survivors. In a biomarker‐restricted multivariable logistic regression model, ESR (OR 1.023 per 1 mm/h increase; 95% CI 1.004–1.042; p = 0.016) and LDH (OR 1.002 per 1 U/L increase; 95% CI 1.000–1.003; p = 0.009) remained significantly associated with in‐hospital mortality after mutual adjustment for the other prespecified inflammatory biomarkers. LDH demonstrated good discriminatory performance (AUC 0.725; 95% CI 0.645–0.805). ESR showed modest discriminatory performance (AUC 0.646; 95% CI 0.559–0.732). Conclusion ESR and LDH remained significantly associated with in‐hospital mortality after adjustment for the other prespecified inflammatory biomarkers. These findings suggest that ESR and LDH may provide adjunctive prognostic information in critically ill ICU patients; however, they should be interpreted in the context of the biomarker‐restricted model and the limited adjustment set. Confirmation in larger prospective studies incorporating established clinical prognostic factors is warranted.
SN - 2398-8835
ER -